Biomedical subjects

Karl J Maier

Publications and source records attributed to Karl J Maier.

4 recordsLinked to original sources

PubMed2005

Diagnosis of hypertension and high blood pressure levels negatively affect cognitive function in older adults.

BACKGROUND: Hypertension is associated with diminished performance on tests of cognitive function. The degree to which those diagnosed with hypertension have controlled blood pressure (BP) levels may be a critical determinant of cognitive outcomes. Persons with hypertension and poorly controlled BP are likely to display the worst performance on cognitive tests. PURPOSE: The purpose is to examine potential interactive relations of hypertension diagnostic status and current BP levels to cognitive function. METHODS: Participants were 101 healthy older adults (ages 53-84, 62% male, 90% White, 29% diagnosed with hypertension) who engaged in biomedical and neuropsychological assessment. RESULTS: After statistical adjustment for age and education, persons with high BP performed more poorly than those with normal BP on the Visual Reproductions-Immediate and Delayed Recall and the Grooved Pegboard tests. Diagnosed hypertension was related to poorer performance on the Grooved Pegboard tests. An interaction of diagnosed hypertension and BP level revealed that those diagnosed with hypertension and also having poorly controlled BP levels performed least well on the Grooved Pegboard tests and the Trail Making Test-Part A. CONCLUSION: Irrespective of prior diagnostic status, individuals with high BP displayed compromised performance on tests of nonverbal memory, motor speed, and manual dexterity. However, as compared to the other groups, those diagnosed with hypertension and also having poorly controlled BP elevation were most vulnerable to difficulties on tests of perceptuo-motor speed, motor speed, and manual dexterity. These findings suggest the need for increased attention to preventative efforts with respect to BP assessment and control in older adults to help preserve cognitive function.

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PubMed2004

Stress-induced blood pressure reactivity and silent cerebrovascular disease.

BACKGROUND AND PURPOSE: Exaggerated blood pressure (BP) responses to mental stress, an index of autonomic dysregulation, have been related to enhanced risk for stroke. This study examined cross-sectional relations of stress-induced BP reactivity to silent cerebrovascular disease assessed by magnetic resonance imaging (MRI) in healthy older adults. METHODS: Sixty-seven nondemented, community-dwelling older adults (ages 55 to 81; 75% male) free of major medical, neurological, or psychiatric disease, engaged in: (1) clinical assessment of resting systolic and diastolic BP; (2) assessment of systolic and diastolic BP responses to 3 laboratory-based mental stressors; and (3) MRI. MRIs were rated for small silent infarcts (> or =3 mm), infarct-like lesions (<3 mm), and periventricular and deep white matter hyperintensities (WMH). RESULTS: After adjustment for age, gender, resting clinic BP, and fasting glucose levels, higher systolic BP reactivity was associated with an increased number of small silent infarcts (r2=0.14; P=0.004) and greater severity ratings of periventricular (r2=0.08; P<0.04) and deep WMH (r2=0.06; P<0.05). Higher diastolic BP reactivity was similarly associated with an increased number of small silent infarcts (r2=0.08; P<0.04), and greater severity ratings of periventricular (r2=0.08; P<0.04) and deep WMH (r2=0.11; P=0.009). CONCLUSIONS: These results indicate that greater stress-induced BP reactivity is associated with enhanced silent cerebrovascular disease on MRI in healthy asymptomatic older adults independent of resting BP levels. Exaggerated stress-induced BP reactivity warrants further examination as a potential biobehavioral risk factor for cerebrovascular disease.

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PubMed2003

Relation of cognitive appraisal to cardiovascular reactivity, affect, and task engagement.

The relation of primary cognitive appraisals to cardiovascular reactivity, affect, task engagement, and perceived stress was examined in 56 men (ages 18-29). Systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate, preejection period, stroke index, cardiac index, and total peripheral resistance were assessed at rest and during performance of a computerized mental arithmetic task. Extending on prior investigations, threat and challenge appraisals were assessed independently from one another and from secondary appraisals. Positive and negative affect, task engagement, and levels of perceived stress were also assessed. Results indicated that threat (R2 =.08, p =.01), challenge (R2 =.14, p =.003), and their interaction (R2 =.11, p =.006) independently predicted DBP reactivity; DBP responses were greatest among participants with a high threat/low challenge pattern of appraisal. Threat appraisals predicted greater negative affect (R2 =.32) and perceived stress (R2 =.48), whereas challenge appraisals were related to greater positive affect (R2 =.44) and task engagement (R2 =.40, ps <.0001). Greater positive affect was correlated with increased SBP and DBP reactivity, and greater levels of task engagement with increased DBP response (ps < or = .002). Results suggest that primary cognitive appraisals are more potent predictors of affect and task engagement than cardiovascular reactivity.

Adaptation, Physiological↗

PubMedDate not supplied

Peripheral arterial disease and cognitive function.

OBJECTIVE: Peripheral arterial disease (PAD) is associated with comorbid atherosclerosis of the coronary and carotid arteries and is a significant risk factor for stroke. However, cognitive function in PAD patients before clinically evident stroke remains poorly characterized. Here we hypothesized that, on neuropsychological testing, PAD patients would perform more poorly than healthy control subjects, and persons with mild cardiovascular disease (essential hypertension), but better than stroke patients, thus reflecting a continuum of cognitive impairment associated with increased severity of vascular disease. METHOD: The cognitive performance of 38 PAD patients (mean ankle-brachial index=0.67, Fontaine Class II) was contrasted with that of 23 healthy normotensive controls, 20 essential hypertensives, and 26 anterior ischemic stroke patients on twelve neuropsychological tests. RESULTS: PAD patients performed significantly more poorly than hypertensives and normotensives, but better than stroke patients, on seven tests of nonverbal memory, concentration, executive function, perceptuo-motor speed, and manual dexterity. Hypertensives displayed poorer performance than normotensives on tests of nonverbal memory and manual dexterity. These findings were independent of age, education, and depression scores. Higher diastolic blood pressure and plasma glucose levels predicted poorer performance of select cognitive tests by PAD patients. Eight to 67% of PAD patients displayed impaired performance (< 5(th) percentile of normotensive controls) on the seven aforementioned cognitive tests. CONCLUSIONS: PAD patients exhibit diminished performance across a variety of domains of cognitive function. Findings also suggest a continuum of cognitive impairment associated with increasingly severe manifestations of cardiovascular disease, thus emphasizing the need for enhanced preventative measures to avert functional declines.

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